| NPI | 1013928035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDIA S SHANNON Office Manager 313-565-6566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI HW007561) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2022-10-16 |